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Heart rate variability biofeedback in Long COVID (HEARTLOC)
No full textIntroduction: Long COVID (LC) refers to symptoms persisting 12 weeks after SARS-COV-2 infection. It affects over 50 million people worldwide, causing varied symptoms including fatigue, breathlessness and palpitations Many of these symptoms can be linked to autonomic nervous system dysregulation (dysautonomia). This proof-of-concept study tests feasibility, and estimates efficacy, of a heart rate variability biofeedback (HRV-B) intervention using a standardised diaphragmatic breathing technique in LC patients.Methods and Analysis: 30 adult LC patients with symptoms of palpitations or dizziness and abnormal NASA Lean Test (NLT) are recruited from a UK COVID-19 rehabilitation service. They undertake an active 4-week HRV-B intervention using a chest strap linked to a HRV phone application while undertaking the breathing technique for 10-min twice daily. Quantitative data including HRV are gathered during the study period using Fitbit, the modified COVID-19 Yorkshire Rehabilitation Scale (C19-YRSm), Composite Autonomic Symptom Score (COMPASS 31), World Health Organisation Disability Assessment Schedule (WHODAS 2.0) and EQ-5D-5L health related quality of life measure. Quantitative data will be analysed using standard statistical tests.Results: This study is ongoing; we have preliminary data for 3 completed participants. They demonstrated mean improvement of 3.7 points (from 16.7 pre-intervention to 13 post-intervention) on C19-YRS symptom severity scale, 1.3 (from 5.3 to 4.0) on C19-YRS functional scale, and 0.6 (from 4.7 to 5.3) on C19-YRS overall health score. Average autonomic score improved by 9.6 (from 47.0 to 37.4). Mean WHODAS score improvement was 4.3 (from 28.5 to 24.2) There was improvement in HRV score and reduction in resting heart rate. Further data will be presented at conference.Conclusion: These preliminary data demonstrate that HRV-B can improve LC symptoms, autonomic symptoms, reduce disability and improve HRV
Photocatalytic biomass reforming: what role will the technology play in future energy systems
No full textPhotocatalytic biomass reforming has emerged as an area of significant interest within the last decade. The number of papers published in the literature has been steadily increasing with keywords such as ‘hydrogen’ and ‘visible’ becoming prominent research topics. There are likely two primary drivers behind this, the first of which is biomass represents a more sustainable photocatalytic feedstock for reforming to value-added products and energy. The second is the transition towards achieving net zero emission targets, which has increased focus on the development of technologies that could play a role in future energy systems. Therefore, this review provides a perspective on not only the current state of the art of research but also a future outlook on the potential roadmap for photocatalysis biomass reforming. Producing energy via photocatalytic biomass reforming is very desirable due to the ambient operating conditions and potential to utilise renewable energy (e.g. solar) with a wide variety of biomass resources. As both interest and development within this field continues to grow, however, there are challenges being identified that are paramount to further advancement. In reviewing both the literature and trajectory of the field, research priorities can be identified and utilised to facilitate fundamental research alongside whole systems evaluation. Moreover, this would underpin the enhancement of photocatalytic technology with a view towards improving the Technology Readiness Level and promoting engagement between academic and industry
Challenging an algorithm built for autism classification using movement data by applying it to data from conditions with similar kinematic styles
No full textComparing the Utility and Disclosure Risk of Synthetic Data with Samples of Microdata
No full textMost statistical agencies release randomly selected samples of Census microdata, usually with sample fractions under 10% and with other forms of statistical disclosure control (SDC) applied. An alternative to SDC is data synthesis, which has been attracting growing interest, yet there is no clear consensus on how to measure the associated utility and disclosure risk of the data. The ability to produce synthetic Census microdata, where the utility and associated risks are clearly understood, could mean that more timely and wider-ranging access to microdata would be possible. This paper follows on from previous work by the authors which mapped synthetic Census data on a risk-utility (R-U) map. The paper presents a framework to measure the utility and disclosure risk of synthetic data by comparing it to samples of the original data of varying sample fractions, thereby identifying the sample fraction which has equivalent utility and risk to the synthetic data. Three commonly used data synthesis packages are compared with some interesting results. Further work is needed in several directions but the methodology looks very promising.</p
Flexible sensors, circuits, and systems for bioelectronic interfacing
No full textBioelectronics is an emerging research area where human-made electronic systems interface, bidirectionally, with the electrical systems present in biology. Flexible electronics are a critical development for bioelectronic systems which can flex and stretch with the body. Printing based manufacturing approaches have been heavily investigated in recent years for creating bioelectronic systems, as screen printing can potentially provide scaled-up roll-to-roll based manufacturing while 3D and inkjet printing can potentially provide opportunities for personalisation. This paper presents a brief narrative review bioelectronics, the materials challenges in flexible sensors, circuits, and systems for bioelectronic interfacing, and examples of our approaches to tackling these challenges
Endoscopic surveillance alone is feasible and safe in type I gastric neuroendocrine neoplasms less than 10mm in diameter
No full textPurposeType I gastric neuroendocrine neoplasms (g-NENs) have a low risk of metastasis and a generally favourable prognosis. Patients with small type I g-NENs (≤10mm) frequently require no treatment, whereas those with larger polyps usually undergo resection. We evaluated the safety and outcomes of endoscopic surveillance after no initial treatment in selected patients with type I g-NENs.MethodsRetrospective analysis of type I g-NEN patients across two European Neuroendocrine Tumour Society Centers of Excellence 2003-2019.ResultsFollowing initial assessment, 87 of 115 patients with type I g-NEN (75 with polyps ≤10mm) received no initial treatment and underwent endoscopic surveillance. 79/87 (91%) demonstrated no clinically meaningful change in tumour size or grade over a median 62 month follow up. Only two patients developed NEN progression that required a change in management and two other patients developed gastric adenocarcinoma/high grade dysplasia; all four initially had ≥11mm g-NENs.ConclusionsPatients with ≤10mm type I g-NENs were unlikely to develop clinically significant tumour progression and in most cases, resection was not needed. The endoscopic surveillance interval could therefore potentially be safely increased to every 2-3 years in such patients. However, lifelong surveillance is still advocated due to the additional risk of developing gastric adenocarcinoma
THE AVOIDING LATE DIAGNOSIS OF OVARIAN CANCER (ALDO) PROJECT; A PILOT NATIONAL SURVEILLANCE PROGRAM FOR WOMEN WITH PATHOGENIC GERMLINE VARIANTS IN BRCA1 AND BRCA2.
No full textBackgrounds To establish ‘real-world’ performance and cost-effectiveness of Ovarian Cancer (OC) surveillance in women with pathogenic germline BRCA1/2 variants deferring risk-reducing salpingo-oophorectomy (RRSO). Methods875 female BRCA1/2-heterozygotes were recruited at 13 UK centres and via an online media campaign, with 767 undergoing at least one 4-monthly surveillance test with the Risk of Ovarian Cancer Algorithm (ROCA® Test). Surveillance performance was calculated with modelling of occult cancers detected at RRSO. Incremental cost-effectiveness ratio (ICER) was calculated using Markov population cohort simulation. Results 8 OCs occurred during 1277 women screen years: 2 occult OCs at RRSO (both stage 1a), and 6 screen-detected; 3 of 6 (50%) were ≤stage 3a and 5 of 6 (83%) were completely surgically cytoreduced. Modelled sensitivity, specificity, PPV and NPV for OC were 87.5% (95%CI, 47.3-99.7), 99.9% (99.9-100), 75% (34.9-96.8) and 99.9% (99.9-100) respectively. The predicted number of quality-adjusted life-years gained by surveillance was 0.179 with an ICER cost-saving of -£102,496/QALY. ConclusionOC surveillance for women deferring RRSO in a ‘real-world’ setting is feasible and demonstrates similar performance to research trials; it down-stages OC, leading to a high complete cytoreduction rate and is cost-saving in the UK setting. Whilst RRSO remains recommended management, ROCA-based surveillance may be considered for BRCA-heterozygotes deferring such surgery
Caries risk assessment related knowledge, attitude, and behaviors among Chinese dentists: A crosssectional survey
No full textObjectivesTo investigate caries risk assessment (CRA)-related knowledge, attitudes, and practices among dentists in China, to describe their subjective ratings of the significance of specific caries risk factors and to identify factors associated with the level of knowledge, attitudes, and use of CRA in routine clinical practice.Materials and MethodsA cross-sectional anonymous online questionnaire survey was performed. The questionnaire was distributed via WeChat (Tencent, Shenzhen, China) to practicing dentists between November 25 and December 25, 2021. For participant recruitment, we employed purposive and snowball sampling techniques. Data were collected using a specialized web-based survey tool (www.wjx.cn) and analyzed with descriptive statistics and regression analyses.ResultsA total of 826 valid questionnaires were collected. Only 292 (35.4%) respondents used CRA in routine practice, among whom a majority (243, 83.2%) did not use a specific CRA tool. The routine use of CRA was associated with the type of practicing office, attendance of caries-related lectures, the habit of reading caries-related literature, geographic location and the total knowledge score. The mean total knowledge score was 3.13 (score range: 0 to 6). Knowledge levels were related to several sociodemographic characteristics, including geographic location, the type of practicing office, attendance of caries-related lectures and the habit of reading caries-related literature. The risk factor deemed most important was “current oral hygiene”.ConclusionsCaries risk assessment has not widely entered clinical practice in China. The level of CRA-related knowledge among dentists was generally suboptimal
Development and external validation of prediction models for adverse health outcomes in rheumatoid arthritis: a multinational real-world cohort analysis
No full textBackgroundIdentification of rheumatoid arthritis (RA) patients at high risk of adverse health outcomes remains a major challenge. We aimed to develop and validate prediction models for a variety of adverse health outcomes in RA patients initiating first-line methotrexate (MTX) monotherapy. MethodsData from 15 claims and electronic health record databases across 9 countries were used. Models were developed and internally validated on Optum® De-identified Clinformatics® Data Mart Database using L1-regularized logistic regression to estimate the risk of adverse health outcomes within 3 months (leukopenia, pancytopenia, infection), 2 years (myocardial infarction (MI) and stroke), and 5 years (cancers [colorectal, breast, uterine]) after treatment initiation. Candidate predictors included demographic variables and past medical history. Models were externally validated on all other databases. Performance was assessed using the area under the receiver operator characteristic curve (AUC) and calibration plots. FindingsModels were developed and internally validated on 21,547 RA patients and externally validated on 131,928 RA patients. Models for serious infection (AUC: internal 0.74, external ranging from 0.62 to 0.83), MI (AUC: internal 0.76, external ranging from 0.56 to 0.82), and stroke (AUC: internal 0.77, external ranging from 0.63 to 0.95), showed good discrimination and adequate calibration. Models for the other outcomes showed modest internal discrimination (AUC < 0.65) and were not externally validated.InterpretationWe developed and validated prediction models for a variety of adverse health outcomes in RA patients initiating first-line MTX monotherapy. Final models for serious infection, MI, and stroke demonstrated good performance across multiple databases and can be studied for clinical use.<br/